带环与直接粘结型颊面管对牙龈沟液中白细胞介素1β及肿瘤坏死因子α水平的影响

Influence of Ring Band Type and Direct Bonding Type Buccal Tube on Interleukin 1β and Tumor Necrosis Factorα Level in Gingival Crevicular Fluid

目的探究并分析带环与直接粘结型颊面管对牙龈沟液中白细胞介素1β及肿瘤坏死因子α水平的影响。方法选取2012年12月至2014年12月开封市第二人民医院收治的固定矫治患者100例,按照随机数字表法分为观察组和对照组,各50例。观察组患者给予直接黏结型颊面管进行矫治,而对照组患者给予带环型颊面管进行治疗。在上装置前及上装置后第6个月复诊,记录患者受试牙牙周健康状况,记录治疗4、8、12周时的临床指标包括牙龈沟液(GCF)、龈沟液中白细胞介素1β(IL-1β)和肿瘤坏死因子α(TNF-α)水平、牙周探诊深度(PD)、抑瘤素-M(OSM)、牙龈指数(GI)。结果治疗后观察组GI、PD、GCF、OSM显著低于对照组[1.37±0.13比1.64±0.12,(2.14±0.45)mm比(2.54±0.51)mm,(5.7±1.1)μL比(7.3±1.2)μL,(16.3±2.1)ng/L比(17.4±2.3)ng/L],差异有统计学意义(P<0.05)。对照组患者随着治疗时间延长,治疗后4周、治疗后8周IL-1β水平逐渐升高,至治疗后12周稍有下降,但仍高于治疗前[(38±8)ng/L、(41±8)ng/L、(39±8)ng/L比(32±7)ng/L],差异有统计学意义(P<0.05)。观察组治疗前、治疗后4周、治疗后8周、治疗后12周IL-1β为(32±6)ng/L、(32±6)ng/L、(34±6)ng/L、(33±6)ng/L,治疗前后无明显变化,差异无统计学意义(P>0.05)。两组治疗后4周、8周、12周TNF-α水平呈上升趋势,且观察组各时间点均低于对照组,差异有统计学意义(P<0.05)。结论固定矫治过程中,黏结型颊面管较带环型颊面管对龈沟液中IL-1β以及TNF-α影响小,值得临床广泛推广。

Objective To explore and analyze the influence of ring band type and direct bonding type buccal tube on interleukin 1βand tumor necrosis factor α level in gingival crevicular fluid. Methods Total of 100 patients with fixed orthodontic treatment in Kaifeng Second People＇s Hospital from Dec. 2012 to Dec.2014 were randomly divided into observation group and control group according to random number table method,50 cases in each group. The observation group was given directly bonded buccal tube for treatment,while the control group was treated with ring band buccal tube treatment. Before fixing on and after 6 months revisit fastening,the periodontal health status and clinical indicators including gingival crevicular fluid（ GCF）,gingival crevicular fluid interleukin 1B（ IL-1Β）,tumor necrosis factor α（ TNF-α）,periodontal probe probing depth（ PD）,oncostatin M（ OSM）,gingival index（ GI） were recorded at treated 4,8,12 weeks. Results After treatment GI,PD,GCF,OSM of the observation group were significantly lower than the control group[1. 37 ± 0. 13 vs 1. 64 ± 0. 12,（ 2. 14 ± 0. 45） mm vs（ 2. 54 ± 0. 51） mm,（ 5. 7 ± 1. 1） μL vs（ 7. 3 ± 1. 2） μL,（ 16. 3 ± 2. 1） ng/L vs（ 17. 4 ± 2. 3） ng/L],the differences were statistically significant（ P〈0. 05） With the treatment progressed,four weeks,eight weeks after treatment IL-1β of the control group increased gradually,then slightly dented after 12 weeks,but still significantly higher than before treatment[（ 38 ± 8） ng/L,（ 41 ± 8） ng/L,（ 39 ± 8） ng/L vs（ 32 ± 7） ng/L],the differences were statistically significant（ P〈0. 05）. Before treatment,after four weeks,eight weeks,12 weeks of treatment IL-1β of the observation group were（ 32 ± 6） ng / L,（ 32 ± 6） ng / L,（ 34 ± 6） ng / L,（ 33 ± 6） ng / L,which showed no statistically significant differences（ P〈0. 05）. After four weeks,eight weeks,12 weeks of treatment the TNF-αlevel of both groups were rising,and the observation group was lower than the control group at each time point（ P〈0. 05）. Conclusion During the orthodontic fixation treatment,compared with the ring band buccal tube,the directly bonded buccal tube has a smaller influence on GCF IL-1β and TNF-α,thus is worthy of clinical application.